Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Katrina Bucklaew, PA

Individual provider Medical Physician Assistant · NPI 1881202158

Katrina Bucklaew, PA is a Physician Assistant in Rochester, New York. Qualified in 2020, 6 years ago. Practices with Western New York Medical Practice PC, a 528-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
6
Licensed in
NY
In the registry since
2020
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1425 Portland Ave
Rochester, NY 14621-3011
Phone: (585) 922-4000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 025254 (NY)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 025254 (NY)

Record details

NPI number1881202158
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 22, 2020
Last updated in NPPESJanuary 25, 2026
Certification dateJanuary 25, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Western New York Medical Practice Pc — 528 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations9 on file with Medicare

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